At the beginning of term, a booth would be set up in the school gym. Stripped to the waist and hunched with cold and embarrassment, we stood waiting for our turn to enter the booth so that the games mistress could watch us bend forward to touch our toes. Then she inspected the soles of our feet. I don’t know if she ever picked up an incipient scoliosis, but each summer verrucas condemned several girls to sitting by the swimming pool while the rest of us practised our breast stroke.
I was in my twenties before I discovered plantar warts of my own. The first crop and I co-existed for ten years. I was working in Cornwall when they spread to my hands. The nurses at the cottage hospital advised me to phone the local wart charmer. I had lived in Cornwall long enough to appreciate belief in the supernatural, and I was fed up with the warts, so I did. The telephone consultation was brief. She didn’t ask many questions. A meeting was not required. My offer of payment was declined. “Leave it to me, my ‘andsome” she said. I did. Within a month I was wart- and verruca-free.
I left Cornwall behind, but not the papilloma virus. A subsequent verruca resisted trial by chemicals, fire and ice. As I was walking on the edge of my foot even in shoes, I stopped telling patients that verrucas are painless. Eventually a podiatrist lasered it. Three years later, same again. Even the up-to-the-minute immune response modifier imiquimod achieved nothing. The plastic surgeon’s laser generated a lot of smoke and a very large hole, but did the trick.
Last January, another one. It’s on the side of my foot this time, and doesn’t cause pain when walking so we are living together in a state somewhere between denial and reluctant acceptance.
Verrucas don’t shorten your life, but they don’t enhance your dignity, and they still worry games teachers. In the future there will be less money for the NHS. ‘Efficiency savings’ never seem to reduce the NHS’s manifold inefficiencies, and it is services that end up being cut.
Should the NHS be treating my verrucas? A small trial – OK, my personal experience – suggests that laser excision is the most effective treatment, but the lady in Cornwall wins on cost. All other treatments scored nul points. But my ankle ligaments still ache after months of walking on the side of my foot. And no-one likes harbouring pests. Sometimes an attempt to help, even if unsuccessful, is valuable. So let’s continue to treat verrucas.
Perhaps the Duke of Cornwall could intervene to provide wart-charming on the NHS?
First published in NASGP Newsletter 'The Sessional GP' June/July 2009
Judith Harvey was a research scientist, ran the VSO programme in Papua New Guinea and taught in a Liverpool comprehensive school before going to medical school. She has been a partner, a salaried GP and a locum, an LMC chair and a long-time supporter NASGP. Her charity, Cuba Medical Link, enables medical students to go to Cuba for their electives.
Judith has now published all her articles from the NASGP website as a new book Perspectives: A GP reflects on medical practice and, well, just about everything…